What to read during radiology residency? The Cafe Roentgen consensus recommendations

Congratulations to all residents for securing a place in radiology residency! Radiology is an exciting and rapidly evolving field with tremendous scope for diverse clinical and research oriented work.

Radiology is also extremely vast and it is impossible to cover the entire length and breadth of the subject in just 3 years of residency. Moreover, in India, we are hardly exposed to radiology during our MBBS training or internship. It is no surprise then that in the first few months of residency, one may feel out of place and disoriented, and at sea in figuring out what to read and from where. With this blog, we hope to highlight the various books which are helpful to read during radiology residency. Needless to say, while books are important, they cannot replace hands-on training.

There is an exhaustive list of radiology textbooks available which can be intimidating to look at. However reading in a planned manner by picking and choosing topics from various books gives comprehensive coverage of the subject.

First things first. Remember, what you read in these few years is what you will practice for life. So you may have read Sembulingam instead of Guyton or Ganong for Physiology during MBBS, but you cannot do that now! You have to now stop reading for the exams, and start reading to become a good radiologist! Pick up and chose the best books and try to grasp as much knowledge as possible. You are the top 10 percentile of NEET ranks; if there is anyone who can do it, it is you!

Radiology reading is slightly complicated compared to other branches of medicine. This is because conventional radiology, USG, CT, MRI, and interventional radiology all have different principles in physics and different books to read from. You also need to read system wise books on say neuroradiology and musculoskeletal radiology. Besides, you need to also be aware radiographic positioning, radiology procedures, radiation safety, contrast-related issues etc. Importantly, while all this is a must know over thee three years, you’ll have to balance beginning with the basics along with reading as per your monthly rotations in USG, CT, MRI etc.

So, the best way to start is two-fold. Start with the basics (radiation safety, contrast-related issues, conventional radiography, radiological procedures and USG) during the evenings and over the weekends, but also focus on case-based learning by reading up what you see each day during your rotations. Also, you will need to learn clinically relevant must know acute emergencies (such as identifying acute intracranial bleeds and infarcts, and approach to acute abdomen) before you venture into the details of head and neck cancer staging. Besides, do remember that there is a wealth of up-to-date online resources from various journals (particularly Radiographics, AJR, and Radiology Clinics) and online radiology websites, including our own Café Roentgen blog! You need to figure out your balance; as you become senior you may start leaning more towards journals and Radiology Clinics editions.

Here is our suggested list of books to read. The list is exhaustive, and you will need to pick and choose based on your comfort level! Created by two of the best Tata Memorial Hospital (passed-out) residents and vetted by the entire Café Roentgen team, we have tried to clarify which are must reads, highly recommended, good to read, recommended for (subspecialty level) comprehensive reading. Each of us have independently gone through the list of books created mainly by Somesh, and have rated the books independently, with our final recommendations based on the feedback from everyone.

General Radiology Books

These textbooks cover basics of all systems. There are two textbooks, and you will have to pick and choose one of them; one of the two is a must read.

  1. Textbook of Radiology and Imaging by David Sutton
  2. Grainger and Allison’s Diagnostic Radiology: A textbook of Medical Imaging.

Grainger has a recent 2020 edition, while Sutton is coming up with a new edition in the latter half of 2022. Everyone will have his or her favourite, but stick to one of them instead of trying to finish both. Ultimately, you will realise that neither book is enough and you will have to dig much deeper to truly know the subject. Nevertheless, these textbooks serve as the base, and often additional information can be gleaned and added as post-its or notes to the textbook chapters to ensure that you can revise everything from a single book close to the exams.

Note that the Berry series has also now been combined into a textbook by merging the individual books. We have described what we like about them later in this article.

Textbooks for Conventional Radiology

These books will help with conventional chest, abdominal and musculoskeletal radiology.

  1. Felson’s Principles of Chest Radiology: MUST READ. Benjamin Felson described almost all signs you will hear of in the first few months of residency. In Dr Ravi Ramakantan words, if there are three books you must read in radiology, they are Benjamin Felson, Benjamin Felson, and Benjamin Felson. Having said that, it is not the easiest book to understand.
  2. The Chest X-ray: A survival Guide by Gerald de Lacey: HIGHLY RECOMMENDED. This has become more popular amongst radiology residents. This book gives more pictorial examples and simplifies the various radiological signs and is easier to digest as compared to Felson.
  3. Bone and Joint Imaging: Resnick and Kransdorf. GOOD TO READ. A good pictorial book for skeletal radiology.

Textbooks for Radiological Procedures

  1. A Guide to Radiological Procedures by Richard Nakielny and Stephen Chapman. MUST READ.
  2. Radiological Procedures – A Guideline by Bhushan N Lakhkar. MUST READ.

The latter is very useful to understand the techniques of doing different procedures and for reading up the compositions of barium etc (an often asked practical exam question).

Books for Physics

One of the radiography books must be read in the first six months. The residents should also themselves perform the radiographs along with processing to better understand the underlying physics.

  1. Christensen’s Physics of Diagnostic Radiology. MUST READ. A very good book to learn conventional, fluoroscopy, CT and Ultrasound Physics. Covers radiation hazards and safety adequately.
  2. The Fundamentals of Imaging Physics and Radiobiology: For the Radiologic Technologist. GOOD TO READ. Gives a more summarised version of physics.
  3. Radiologic Science for Technologists: Physics, Biology and Protection by Stewart Bushong. GOOD TO READ. Has good diagrams and flowcharts to understand the concepts. Computer Radiography, Digital Radiography, Mammography and DSA are covered well.
  4. MRI made easy (for Beginners) by Dr.Govind B Chavhan. MUST READ. An excellent book to understand the MR physics, we would recommend reading it just before or during the first MRI rotation.
  5. MRI in practice by Carolyn Roth, Catherine Westbrook and John Talbot. GOOD TO READ. Another simplified book to understand NMR physics. Chose one of the two unless you are really into MRI physics!
  6. ACR Guidance Document on MR Safe Practices: GOOD TO READ. Covers all the relevant topics on MRI safety, currently a hot topic in Radiology.
  7. Farr’s physics for medical imaging. More detailed, this is a must read for those planning to prepare for FRCR; so might as well read this early on!

Books for managing practical radiology issues

Known unknowns of Everyday Radiology Practice: A practical radiology Handbook by Bhavin Jankharia and Akshay Baheti. MUST READ. We would recommend reading it in the first few months for reviewing the latest guidelines and SOPs on contrast media usage, radiation safety, and imaging in pregnancy, besides chapters on how to take consent, use of checklists, reporting etc. It covers common problems and clinical scenarios encountered in day to day practice.

Dr Bhavin Jankharia has also created a video on how to take consent for the book. You can view it here. It is a MUST WATCH for every resident to understand the nuances of taking consent, along with the corresponding chapter in the book.

Books for Radiological Anatomy

These are not the books to be ‘read’ but are ready reckoners to identify the structure while routine reporting.

  1. Weir and Abraham’s Imaging Atlas of Human Anatomy, 5th It covers both conventional and cross-sectional anatomy, and is an excellent reference book.
  2. Pocket Atlas of Sectional Anatomy: Computed Tomography and Magnetic Resonance Imaging.

Books for Radiological Positioning

Covers the various views of conventional radiography. A radiologist can give good reports only if the images are optimally acquired. Positioning is of utter importance to get good images. Furthermore, these are frequently asked by the examiners during practicals and you could be asked to demonstrate the position/take the x-ray as well.

  1. Clark’s Positioning in Radiography. MUST READ. Residents should ideally read this and then acquire the images themselves to cement it in their memory.
  2. Planning and Positioning in MRI by Anne Bright. GOOD TO READ. Gives a detailed account of planning and positioning in MRI for all major scans.

System wise Books

Neuroradiology:

  • Osborn’s Brain Imaging, Pathology and Anatomy. MUST READ. No need to say anything further about this fantastic book!
  • Scott Atlas Magnetic Resonance Imaging of the Brain and Spine. RECOMMENDED FOR COMPREHENSIVE SUBSPECIALTY READING. While exhaustive, it is a great add-on to Osborn for those who love neuroradiology, and the chapters on epilepsy and spine are exceptionally good, and may be read during regular residency.
  • Diagnostic Imaging Brain, 3rd Edition. HIGHLY RECOMMENDED. It is a great book for unusual cases.
  • Barkovich Pediatric Neuroimaging: RECOMMENDED FOR COMPREHENSIVE SUBSPECIALTY READING. This is THE reference book for pediatric neuroradiology.

Head and Neck Radiology:

  • Diagnostic and Surgical Imaging Anatomy of brain, head and Neck and Spine by Hansberger, Osborn, Macdonald and Ross. GOOD TO READ. Hansberger’s handbook is another book which can be read if there is lack of time.
  • Head and Neck Imaging by Peter M Som and Hugh D Curtin. RECOMMENDED FOR COMPREHENSIVE SUBSPECIALTY READING (REFERENCE BOOK). This book is the Holy Grail of Head and Neck imaging. Too exhaustive for a complete read, you should read at least the important topics from it, and use it as a reference book whenever you need to read more details on any topic.

Cardiovascular and thoracic:

  • Thoracic Imaging: Pulmonary and Cardiovascular Radiology by W. Richard Webb and Charles B Higgins. MUST READ.
  • High Resolution CT (HRCT) of the lung by W. Richard Webb, Nestor L. Müller and David P Naidich. GOOD TO READ.

Body Imaging:

  • Diagnostic Imaging Gastrointestinal, 3rd
  • Diagnostic Imaging Genitourinary, 3rd
  • Textbook of Gastrointestinal Radiology by Gore and Levine: GOOD TO READ. The older edition is a classic for barium and fluoroscopy studies. The newer edition gives comprehensive coverage on newer modalities as well.

The DI series can probably be skipped if you read Haaga or Lee and Segal (see ahead).

Musculoskeletal:

  • Clyde Helms’ Fundamentals of Skeletal Radiology: MUST READ. Also known as ‘The Pink Book’, this small 250 page book is the perfect introduction to skeletal radiology for beginners, written in Helms’ classic witty style. This must be read in the first year of residency.
  • Musculoskeletal MRI by Helms and Major: Covers most of the fundamentals of musculoskeletal MRI well. GOOD TO READ.
  • Orthopedic Imaging: A Practical Approach by Adam Greenspan. GOOD TO READ. Excellent for those who want to read musculoskeletal imaging in detail and pursue a career in musculoskeletal radiology.
  • Yochum and Rowe’s Essentials of Skeletal Radiology. MUST READ. Excellent image rich and concept rich two-volume book on conventional MSK radiology.
  • Bone and Joint Imaging: Donald Resnick. RECOMMENDED FOR COMPREHENSIVE SUBSPECIALTY READING (REFERENCE BOOK). The Bible – it is the equivalent of Grey’s anatomy; everyone knows it but no one has read it. However, the chapter on Bone physiology and architecture is highly recommended to understand the concepts of metabolic bone disease (rickets, scurvy, osteomalacia, osteoporosis etc).

Modality wise Books

We have already covered books for conventional imaging above.

Ultrasound and Doppler:

  • Diagnostic Ultrasound by Carol M Rumack, Stephanie R Wilson, J William Charboneau and Deborah Levine. MUST READ.
  • Introduction to Vascular Ultrasonography by Zwiebel and Pellerito. MUST READ.
  • WHO Manual of Diagnostic Ultrasound. The composition of ultrasound jelly and patient positioning are two topics which should be read from it.
  • Callen’s Ultrasonography in Obstetrics and Gynecology. RECOMMENDED FOR COMPREHENSIVE SUBSPECIALTY READING. The definite book on obstetric ultrasound for the future sonologists!

Cross Sectional Imaging:

  • CT and MRI of the whole body by John Haaga and Daniel Boll. MUST READ
  • Computed body tomography with MRI correlation by Joseph Lee and Stuart Sagel. GOOD TO READ.

Haaga has a more recent edition, and is more up-to-date; and is hence recommended over Lee and Sagel’s book. Having said that, you will learn maximum on cross-sectional imaging by simply reading more and more scans!

Interventional Radiology: Handbook of Interventional Radiologic Procedures by Kandarpa. RECOMMENDED FOR COMPREHENSIVE SUBSPECIALTY READING.

Nuclear Medicine: Diagnostic Imaging Nuclear Medicine. RECOMMENDED FOR COMPREHENSIVE SUBSPECIALTY READING.

Books for Differential Diagnoses:

There are many number of books (including system wise) for radiological differentials. However, we found the following to be most useful.

  • Aids to Radiological Differential Diagnosis by Richard Nakielny and Stephen Chapman. Recommend all resident to carry a copy of same every day during training (either hard copy or on your tablets).
  • Radiology review manual by Wolfgang Dahnert. Too extensive but can be used as a reference manual

Orphan Topics

  • Recent Advances. Often, newer techniques and advances are not well covered in the text books. You will have to use various online resources to read these. Having said that, many of the ‘recent advances’ questions commonly encountered in theory examinations are covered well in Diagnostic Radiology: recent advances and applied physics – AIIMS-MAMC-PGI Imaging series (Popularly known as Berry’s).
  • PCPNDT ACT (we are not kidding!). A very important medicolegal aspect of practicing radiology in India. One should go through this act including recent amendments posted on the ministry of health and family welfare website. In addition, be aware of the practicalities of the act applicable to your institute.
  • Atlas of Normal Roentgen Variants That May Simulate Disease by Theodore Keats. Commonly known as Keats Atlas, this is must have in every radiology dept so as to serve as a reference book when required. Everyone must go through it for ‘timepass’ to realise how often anatomical variants can simulate disease; it has helped every radiologist umpteen number of times to confidently not call a variant ossicle as a fracture.
  • Radiology of Syndromes, Metabolic Disorders and Skeletal Dysplasias by Taybi and Lachman. The go to reference book for this topic; this is another must have in every radiology dept.
  • William Walter Greulich, Sarah Idell Pyle. Radiographic Atlas of Skeletal Development of the Hand and Wrist. Another must have in the dept for estimating bone age.
  • Caffey’s Pediatric Diagnostic Imaging: This is the reference book for pediatric radiology; we would recommend reading common pediatric topics from it.
  • You may need to understand research and statistical methodology in order to prepare a good thesis. A good way to begin would be to read the STARD guidelines and this radiographics article on basic statistics. If you are academically inclined, it will be good to delve deeper into this fascinating topic during your thesis.
  • And finally, do not miss reading our blog section on ‘The art and science of radiology reporting’. Similarly, if you are thinking of pursuing higher studies or abroad or settling abroad, do read our section on ‘Beyond the shores’.

Online Resources

There are innumerable online resources available for radiology residents, and we are sharing the link to Ameya’s ECR poster covering the important ones.

  1. Whenever you come across topics not covered adequately in textbooks (and this will happen often), search online. These topics, in all likelihood, will have dedicated review articles in journals like Radiographics, Radiology, American Journal or Radiology, and Radiological Clinics of North America (RCNA). RCNA often has great volumes on dedicated topics which can replace textbooks for reading.
  2. There are also online sources like Radiopaedia, Radiology Assistant, Learning Radiology etc., which are useful for immediate reference. These however should be used only for short-term reference and should not replace textbooks/journals.
  3. Go through online cases such as those on Aunt Minnie and ACR case of the day. Dr Ravi Ramakantan’s case of the week with answers and explanations written by himself are a must go though.
  4. It would be a good idea to invest in a tablet and keep the most useful articles and Kindle books in a dedicated folder/ library on it. You will be able to read, annotate and save, and it will serve as an online repository for everything interesting you come across in the future. It also makes it easier to refer to an article quickly when you come across a case and need to read up a bit. For example, various ACR recommendations on management of incidentalomas or Som and Curtin’s article on cervical nodal staging on CT are articles you can keep in this library for ready reference.

Exam Focused Reading

There is a trend to read separate ‘exam focused’ books as the MD exams approach. This is usually not helpful and we would suggest avoiding it; it is better and easier to revise textbooks you have already read throughout your residency. A few exceptions may be dedicated books on Pediatric Imaging and on Recent Advances. The two most common sets of books which are most popular amongst residents are

  1. Diagnostic Imaging Series and
  2. Diagnostic Radiology: recent advances and applied physics: AIIMS-MAMC-PGI Imaging series (Popularly known as Berry’s).

Remember, this is just the beginning of the journey. The basic principle is to know your basics well across all topics, and then read what interests you most in more detail. At the sake of being repetitive (or worse still, sounding like Amir Khan!), read to become a good radiologist and not to pass the exams; the latter will happen automatically. You will naturally read topics of interest or subspecialization in even further detail during senior residency/fellowship. If you wish to give USMLE or FRCR, leave that to the post residency year/ bond year; don’t spend time on it during residency.

All the best for the ride of your lifetime!

– Somesh Singh

– Ameya Kawthalkar

– Akshay Baheti

– Ankita Ahuja

– Chinmay Mehta

– Palak Popat

9 thoughts on “What to read during radiology residency? The Cafe Roentgen consensus recommendations

  1. Akshay, you have pretty much covered everything.
    I have just this SERIOUS bit of ADVICE for all residents.
    Read on a case:
    I mean – if today, you saw a case (No, I did not say interesting case!), about which you knew little or nothing at all, -read about it before the day is out. READ FROM TEXTBOOKS. NOT from Radiopedia or the like. Textbooks are not written for nothing.
    This way, you will not have to struggle to cram things during the ‘exam leave’. That is the worst way to learn Radiology.
    And remember this old saying:
    Often in life, the longest way around is the shortest way home.
    Ravi

    Liked by 1 person

  2. Dr Shraddha Sinhasan

    This has forever been a dilemma.. what is must read n which are the reference books for residency in Radiology as we have to cover all systems..u have also included online articles which is grt.. will definitely forward to all residents👍🏻

    Liked by 1 person

  3. Pingback: Online Learning Resources for the Radiologist – Cafe Roentgen

  4. Govind B. Chavhan

    Cafe Roentgen is a great initiative Akshay! Congratulations and thank you for providing guidance to tomorrow’s radiologists!
    As Ravi sir has aptly said above ‘Often in life, the longest way around is the shortest way home.’
    Along the same line, I remember one quote by WIlliam Osler about reading that is plaqued at the entrance of KEM library:
    “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all” ― William Osler
    Best wishes,
    Govind

    Like

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